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Discuss some of these challenges and conflicting visions. In what ways was the Ebola epidemic a product of global health’s history, i.e. the failure to address the underlying conditions that generated the epidemic?

Discuss some of these challenges and conflicting visions. In what ways was the Ebola epidemic a product of global health’s history, i.e. the failure to address the underlying conditions that generated the epidemic?

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Discuss some of these challenges and conflicting visions. In what ways was the Ebola epidemic a product of global health’s history, i.e. the failure to address the underlying conditions that generated the epidemic? 

 

CONCLUSION Responding to Ebola OPENED THIS BOOK with a discussion of the Ebola outbreak that began in sistance. I will close by returning to West Africa to examine the international response to the epidemic-a response that reflected many of the challenges and conflicting visions that have marked the history of global health. The global response to the West African Ebola outbreak, which had killed over 8000 people by January 2015, unfolded slowly. A team of phy- sicians working for Doctors Without Borders/Médicins Sans Frontières (MSF) confirmed the presence of Ebola in Guinea in March 2014. By April, the disease was spreading beyond the country's borders, yet the World Health Organization was reluctant to label it an epidemic. WHO spokes- person Gregory Hartl played down the importance of the outbreak at an April news conference in Geneva, saying, “Ebola already causes enough and we need to be very careful about how we characterize some- thing which up until now an outbreak with sporadic cases."¹ WHO Director-General Margaret Chan was reluctant to the alarm about what was occurring in West Africa, in part because she had been criticized for her earlier warning about the threat of the H1N1 virus in 2009, and in part because a number of earlier outbreaks of Ebola in East and Central Africa had been successfully contained. concern, MSF, which had sent teams to the region to open clinics and emergency hospitals soon after Ebola was confirmed, strongly disagreed, warning, "We are facing an epidemic of a magnitude never before seen in terms of the distribution of cases in the country."2 MSF called for a much more ro- bust response from the world community. WHO, however, did not declare that the outbreak was a global-health emergency until August 9, 2014, and 329
Transcribed Image Text:CONCLUSION Responding to Ebola OPENED THIS BOOK with a discussion of the Ebola outbreak that began in sistance. I will close by returning to West Africa to examine the international response to the epidemic-a response that reflected many of the challenges and conflicting visions that have marked the history of global health. The global response to the West African Ebola outbreak, which had killed over 8000 people by January 2015, unfolded slowly. A team of phy- sicians working for Doctors Without Borders/Médicins Sans Frontières (MSF) confirmed the presence of Ebola in Guinea in March 2014. By April, the disease was spreading beyond the country's borders, yet the World Health Organization was reluctant to label it an epidemic. WHO spokes- person Gregory Hartl played down the importance of the outbreak at an April news conference in Geneva, saying, “Ebola already causes enough and we need to be very careful about how we characterize some- thing which up until now an outbreak with sporadic cases."¹ WHO Director-General Margaret Chan was reluctant to the alarm about what was occurring in West Africa, in part because she had been criticized for her earlier warning about the threat of the H1N1 virus in 2009, and in part because a number of earlier outbreaks of Ebola in East and Central Africa had been successfully contained. concern, MSF, which had sent teams to the region to open clinics and emergency hospitals soon after Ebola was confirmed, strongly disagreed, warning, "We are facing an epidemic of a magnitude never before seen in terms of the distribution of cases in the country."2 MSF called for a much more ro- bust response from the world community. WHO, however, did not declare that the outbreak was a global-health emergency until August 9, 2014, and 329
not until October did significant additional aid begin reaching the three most affected countries. There is no doubt that the delayed global response contributed to the spread and severity of the epidemic. With the discovery of the first case of Ebola in the United States in Sep- tember 2014, the Ebola outbreak suddenly became a global health emer- gency. This one case stimulated increased US commitments to fighting the disease in West Africa, including the promise of several thousand US mili- tary troops to help with logistics. The US Congress was asked for US$4.6 billion dollars, most of it to go to strengthening disease preparedness in the United States, global surveillance systems, and vaccine and drug develop- ment. Private foundations committed over US$100 million to support control efforts in West Africa. When aid began pouring in, it traveled along well-trodden colonial pathways, with the United States sending money and 2400 military troops to Liberia, the British sending resources primarily to its former colony in Sierra Leone, and the French doing the same for its former colony in Guinea. Channeling aid in this way ignored the regional nature of the epidemic and the need to coordinate relief activities across borders. In the meantime, dozens of international NGOs arrived, working as best they could to help stabilize the situation. There was very little coordination among these various groups, however, and no one was in charge. WHO, which should have played this role, lacked the resources to do so. After the 2008 financial crisis, its overall budget had been cut to roughly US$2 billion, or less than that of some major medical centers in the United States. Most outside contributions to WHO were directed to categorical programs, such as polio eradication. WHO's emergency-response office had had its budget cut by 51 percent. Again underplaying the need for regional coordination, Director-General Chan preferred to have the countries them- selves coordinate activities within their own borders. The three most affected countries, however, had a limited capacity to mobilize or coordinate the re- lief response. Lacking coordination, NGOs employed different protocols, duplicated efforts, and, in some cases, overbuilt facilities, setting up beds that remained empty. Early foreign assistance led to the creation of Ebola case-management centers but did not provide trained staff to run them.³ In Liberia, where most of the US funding was directed, almost all of the support went to building facilities in the capital, Monrovia, while rural areas, where many cases were occurring, received little attention. International actors, moreover, seemed unable to adapt quickly to a rapidly changing situation. Resources were being allocated to activities that were no longer appropriate. In Monrovia, 330 A HISTORY OF GLOBAL HEALTH
Transcribed Image Text:not until October did significant additional aid begin reaching the three most affected countries. There is no doubt that the delayed global response contributed to the spread and severity of the epidemic. With the discovery of the first case of Ebola in the United States in Sep- tember 2014, the Ebola outbreak suddenly became a global health emer- gency. This one case stimulated increased US commitments to fighting the disease in West Africa, including the promise of several thousand US mili- tary troops to help with logistics. The US Congress was asked for US$4.6 billion dollars, most of it to go to strengthening disease preparedness in the United States, global surveillance systems, and vaccine and drug develop- ment. Private foundations committed over US$100 million to support control efforts in West Africa. When aid began pouring in, it traveled along well-trodden colonial pathways, with the United States sending money and 2400 military troops to Liberia, the British sending resources primarily to its former colony in Sierra Leone, and the French doing the same for its former colony in Guinea. Channeling aid in this way ignored the regional nature of the epidemic and the need to coordinate relief activities across borders. In the meantime, dozens of international NGOs arrived, working as best they could to help stabilize the situation. There was very little coordination among these various groups, however, and no one was in charge. WHO, which should have played this role, lacked the resources to do so. After the 2008 financial crisis, its overall budget had been cut to roughly US$2 billion, or less than that of some major medical centers in the United States. Most outside contributions to WHO were directed to categorical programs, such as polio eradication. WHO's emergency-response office had had its budget cut by 51 percent. Again underplaying the need for regional coordination, Director-General Chan preferred to have the countries them- selves coordinate activities within their own borders. The three most affected countries, however, had a limited capacity to mobilize or coordinate the re- lief response. Lacking coordination, NGOs employed different protocols, duplicated efforts, and, in some cases, overbuilt facilities, setting up beds that remained empty. Early foreign assistance led to the creation of Ebola case-management centers but did not provide trained staff to run them.³ In Liberia, where most of the US funding was directed, almost all of the support went to building facilities in the capital, Monrovia, while rural areas, where many cases were occurring, received little attention. International actors, moreover, seemed unable to adapt quickly to a rapidly changing situation. Resources were being allocated to activities that were no longer appropriate. In Monrovia, 330 A HISTORY OF GLOBAL HEALTH
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Introduction

Between 2013 and 2016, the Ebola epidemic hit West African regions, resulting in several thousand' deaths and disrupting the socioeconomic setup of the west African region. One of the worst hit countries by the Ebola virus was Liberia, followed by Sierra Leone and Guinea. The first case of the disease was registered in 2013 in Guinea. 

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